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Individual

ELLIS ROBERT TINGSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
8813 31ST AVE SW, SEATTLE, WA 98126-3718
(206) 355-1981
Mailing address
8813 31ST AVE SW, SEATTLE, WA 98126-3718
(206) 355-1981

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60113260
WA

Other

Enumeration date
12/14/2009
Last updated
12/14/2009
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